Duodenal Switch vs. Lap Band2019-01-26T06:53:26+00:00

Duodenal Switch vs. Lap Band

Duodenal Switch

A Lighter Me does not recommend the duodenal switch procedure. A gastric sleeve operation is more affordable and often has less complications.

Overview

Duodenal switch surgery combines a sleeve gastrectomy and an intestinal bypass. During this procedure, approximately 60 to 70 percent of the stomach is removed; this results in the stomach forming into the shape of a tube. After that, two thirds or more of the intestine is bypassed, which leaves only a few feet inside the intestine where digestive enzymes and food can meet; this causes malabsorption. After surgery, the body will be unable to absorb a majority of the calories and nutrients that are eaten, so very high weight loss often occurs. This procedure got its name because the duodenum, the first part of the intestine, is divided and attached to the lower section of the small intestine. The pylorus, the outlet muscle that controls the emptying of the stomach, is preserved during this surgery; this often results in dumping syndrome. This surgery has been shown to result in the most reliable and longest lasting results of all weight loss procedures.

Patient Eligibility

Good candidates for this surgery have a body mass index (BMI) greater than 40. Individuals with lower BMIs may still be eligible for this procedure if they have weight-related medical problems.

Average Weight Loss Results

Most patients lose between 60 and 80 percent of their excess body weight over a 2-year period. Ten years after surgery, most patients have shown to still have a total weight loss of approximately 70 percent.

Recovery Time

The average recovery time is between 3 and 4 weeks.

Common Side Effects

After duodenal switch surgery, patients often experience decreased absorption, which causes more frequent and looser bowel movements and increased flatulence. Patients should also be closely monitored for vitamin, mineral, and protein deficiencies, due to the decrease in the absorption of nutrients.

Cost

Most insurance companies will not cover this surgery, and it can cost as much as $20,000.

References:

http://www.columbiasurgery.org/conditions-and-treatments/duodenal-switch-bpd-ds

Lap Band (Adjustable Gastric Band)

A Lighter Me does not recommend the lap band procedure. A gastric sleeve operation is more affordable and often provides better results.

Overview

Adjustable gastric band surgery is done laparoscopically. It is considered one of the least invasive weight loss surgeries. During the procedure, the surgeon makes small incisions in the upper abdomen and then places a soft silicone ring with an expandable balloon around the top of the stomach. The silicone ring, or band, creates a small stomach pouch, which causes the patient to feel full after eating only a small amount of food. The band is adjustable; fluid can be added to or removed from the balloon through a port that is placed under the skin. The reduction in the intake of food, due to the patient feeling fuller more quickly, can result in significant weight loss.

Patient Eligibility

Individuals who have certain stomach or intestinal disorders, take aspirin frequently, or are addicted to alcohol or drugs are not eligible for this procedure. This procedure is only performed on individuals who are 18 or older.

Average Weight Loss Results

Weight loss results vary widely based on patient motivation and compliance. On average, most patients lose approximately 40 to 60 percent of their excess body weight after this procedure. Initially, most patients can expect to lose about 2 or 3 pounds per week, and then their weight loss will drop to about one pound per week. Adjustments to the band can be made if necessary.

Recovery Time

Most people are able to return to work one week after the procedure, and they can resume normal activities after 6 weeks.

Common Side Effects

This procedure has a moderate risk of long-term complications. Between 15 and 60 percent of patients end up needing to have the procedure completed again due to implant malposition, erosion, frequent vomiting, or lack of weight loss. Common side effects include nausea, vomiting, constipation, indigestion, ulceration at the band site, dehydration, and weight regain.

Cost

The cost of this procedure varies, but on average it costs approximately $3,500 with insurance and $15,000 without insurance.

References:
https://www.medicinenet.com/lap_band_surgery_gastric_banding/article.htm#who_are_candidates_for_the_lap_band_system
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/laparoscopic_adjustable_gastric_banding_135,63